# data[].attributes.body
http://www.cdtl.nus.edu.sg/tlhe/tlhe2014/abstracts/gohps.pdf

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http://www.cdtl.nus.edu.sg/tel2013/abstracts/Tel2013-abstracts.pdf

(page 71 to 74)

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http://www.cdtl.nus.edu.sg/tel2013/papers.htm

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Technology enhanced Learning (TeL2013): Symposium Schedule

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PROGRAMME | KEYNOTE SPEAKERS | WORKSHOPS | GALLERY | COMMITTEE | VENUE | Contact

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http://www.cdtl.nus.edu.sg/tel2013/papers.htm

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Singapore International Foundation Program, Colombo, Sri Lanka

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Singapore International Foundation Program, Colombo, Sri Lanka

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http://elearningrepository.blogspot.sg/

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Dr Goh Poh Sun. MBBS(Melb), FRCR(UK), FAMS(Singapore), MHPE(Maastricht), FAMEE. Associate Professor and Senior Consultant, Department of Diagnostic Radiology, National University Hospital, Singapore. Over 25 years of experience in clinical radiology and over 20 years teaching. Special interest in Neuroradiology, Chest and Abdominal Radiology. Over 15 years of experience in technology enhanced learning.

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http://learningabdominalradiology.blogspot.sg/2014/11/m3-medical-student-case-review-1245hrs.html

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(e)Learning

http://mededworld.org/reflections/reflection-items/September-2013/(e)Learning.aspx (reflection on eLearning)

http://www.slideshare.net/dnrgohps/for-med-edworldpublishpohsungoh

(use of case pairs can potentially improve the efficiency and effectiveness of radiology training)

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M3(Surgery Posting), Clinical Group 38, 39 and 43 medical student Case Review @ 1245hrs, Conference Room, Department of Diagnostic Imaging, Level 2, NUH on November 5, 2014

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http://learningabdominalradiology.blogspot.sg/2014/10/radiology-resident-tutorial-october.html

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(e)Learning

http://mededworld.org/reflections/reflection-items/September-2013/(e)Learning.aspx (reflection on eLearning)

http://www.slideshare.net/dnrgohps/for-med-edworldpublishpohsungoh

(use of case pairs can potentially improve the efficiency and effectiveness of radiology training)

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Radiology Resident Tutorial, October 10th, 2014 @ 0745hrs to 0845hrs

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http://medicaleducationelearning.blogspot.sg/2014/05/elearning-workshop-on-wednesday-23rd.html

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---------------------

"Message to workshop participants -

Thank you for signing up for this workshop. My presentations on the topics for the workshop will be based on the material on this website. The pre-reading for the workshop, and presentations will be given entirely from the website below.

http://padlet.com/dnrgohps/eLearningWall

The overview of the program for this workshop is displayed graphically below.

Please explore the content, and reflect on the engagement process as well.

May I invite you to post comments, and questions on the "add your comments" section in this blog below. Please also post in the comments section how you currently use; or are thinking of using eLearning or Technology Enhanced Learning in your own teaching.

Alternatively, I have also set up a "digital wall" for all workshop participants, and faculty to record and share their thoughts (see website/link below). You all have permission/digital rights to post and modify your contributions at any time. Please make use of this digital wall - and please title your contribution, include your name; then share your thoughts; pose questions; share documents, videos, links, or any other contribution you feel would add to the discussion.

http://padlet.com/dnrgohps/eLearningWall

All you need to do is to double click on any clear space on the digital wall on the website above. You do not need to log-in or sign up. And you can modify your post, add to, or delete the post at any time.

_________________

As a specific pre-workshop task, please answer the following questions about yourself, by making a post on the digital wall http://padlet.com/dnrgohps/eLearningWall BEFORE the workshop (by Friday, the week before the workshop please).

1. Tell us a little about yourself (please also identify yourself/give name)

a. background - current clinical, educational or administrative practice, number of years active, practice setting
b. experience and training in eLearning/technology enhanced learning - e.g. pick up as you go along, workshops, courses, formal training (Masters)
c. What barriers/challenges are you currently facing/have you encountered in integrating technology into teaching?

and

2. Share an educational project you intend to use eLearning for (current or planned/upcoming)

a. aim
b. how you intend or hope to use eLearning

___________________

For those of you who prefer traditional literature reviews and articles, please review the following before the workshop.

1. AMEE Guide 32: e-Learning in medical education
Part 1: Learning, teaching and assessment
http://informahealthcare.com/doi/abs/10.1080/01421590802108331
Rachel Ellaway & Ken Masters, Medical Teacher, 2008, 30: 455-473.

2. eLearning in clinical teaching
http://www.faculty.londondeanery.ac.uk/other-resources/files/BJHM_article%2012_%20e-learning.pdf
Ian Doherty, Judy McKimm
British Journal of Hospital Medicine, January 2010, Vol 71, No 1

3. What do we mean by web‐based learning? A systematic review of the variability of interventions
http://scholar.google.com/citations?view_op=view_citation&hl=en&user=RbXpT6kAAAAJ&citation_for_view=RbXpT6kAAAAJ:IWHjjKOFINEC
DA Cook, S Garside, AJ Levinson, DM Dupras, VM Montori
Medical education 44 (8), 765-774
2010

4. Instructional methods and cognitive and learning styles in web‐based learning: report of two randomised trials
http://scholar.google.com/citations?view_op=view_citation&hl=en&user=RbXpT6kAAAAJ&cstart=20&citation_for_view=RbXpT6kAAAAJ:Se3iqnhoufwC
DA Cook, MH Gelula, DM Dupras, A Schwartz
Medical education 41 (9), 897-905
2007

5. Time and learning efficiency in Internet-based learning: a systematic review and meta-analysis
http://scholar.google.com/citations?view_op=view_citation&hl=en&user=RbXpT6kAAAAJ&cstart=20&citation_for_view=RbXpT6kAAAAJ:HDshCWvjkbEC
DA Cook, AJ Levinson, S Garside
Advances in health sciences education 15 (5), 755-770
2010

6. Computer animations in medical education: a critical literature review
http://scholar.google.com/citations?view_op=view_citation&hl=en&user=RbXpT6kAAAAJ&cstart=20&citation_for_view=RbXpT6kAAAAJ:ULOm3_A8WrAC
JG Ruiz, DA Cook, AJ Levinson
Medical education 43 (9), 838-846
2009

7. Preparing for the changing role of instructional technologies in medical education
http://scholar.google.com/citations?view_op=view_citation&hl=en&user=RbXpT6kAAAAJ&cstart=20&citation_for_view=RbXpT6kAAAAJ:iH-uZ7U-co4C
BR Robin, SG McNeil, DA Cook, KL Agarwal, GR Singhal
Academic Medicine 86 (4), 435-439
2011

Lastly, please bring your personal WiFi/3G/4G enabled tablet or laptop to the workshop. You should have examples of your teaching content on the tablet or laptop. You will be using this tablet or laptop for the workshop activities.

Very best regards,

Poh Sun"

GOH Poh Sun
MBBS(Melb), FRCR(UK), FAMS(Singapore), MHPE(Maastricht)
Associate Professor and Senior Consultant
Department of Diagnostic Radiology
National University Hospital
National University Health System
Singapore
Email: dnrgohps@nus.edu.sg

Brief Bio:
Dr Goh is a clinician educator who currently devotes 80% of his time to clinical practice and postgraduate training; and 20% of time to educational research. This has been supplemented over the last three years by daily two to three hour early morning sessions focused on creating, curating and sharing (anonymised) case based educational teaching resources on a variety of digital and mobile learning platforms, from a digital repository currently containing over 5000 digital teaching and learning objects. 25/21/13: years of experience as a clinical radiologist/educator/technology enhanced learning practitioner.

"Passions - Technology enhanced learning, Education, Radiology. Technology as a tool, platform and enabler to support and augment face to face customised teaching and learning; with educational principles as the foundation; and radiology as my academic and clinical focus."

http://sg.linkedin.com/pub/poh-sun-goh/22/45b/b16 (LinkedIn profile)
http://www.slideshare.net/dnrgohps/documents and http://www.slideshare.net/dnrgohps/presentations
(Education presentations and papers)

How Learning Works: Seven Research-Based Principles for Smart Teaching - Susan Ambrose et al. (2010), see links below

How The Brain Learns - David A. Sousa (2011), see links below

How People Learn - National Science Foundation (2004)

Helping Students Learn in a Learner-Centered Environment - Terry Doyle (2008), see links below

(the website is free, AND allows collaboration and brainstorming, while documenting discussions, and promoting sharing)

Can we build the perfect teacher?

Priced to sell - Is free the future?

The long tail

Social Sharing Companies such as Airbnb and Uber, which have a social mission and are also social marketplaces, are able to access all three social value drivers: Advocacy, Connection, and Collaboration. The revolutionary power of Airbnb and Uber comes from their ability to harness technology to create a social sharing platform that facilitates trust by creating transparency and dual accountability. This enables individuals to form weak ties (i.e. Bridging Social Capital) with one another, leading to the personal sharing of goods and/or services (i.e. Linking Social Capital) by Barbara Gray (on LinkedIn Post)

Video - How to land plane in an emergency (reflection exercise)

# data[].attributes.attachment_link.title
eLearning workshop on Wednesday, 23rd July, 2014

# data[].attributes.attachment_link.description
"Message to workshop participants - Thank you for signing up for this workshop. My presentations on the topics for the workshop will be based on the material on this website. The pre-reading for the workshop, and presentations will be given entirely from the website below.

# data[].attributes.body
http://designingeffectivelearning.blogspot.sg/

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Cognitive Theory and the Design of Multimedia Instruction: An Example of the Two - Way Street Between Cognition and Instruction

Principles of multimedia learning based on a cognitive theory of multimedia learning

(number of tests / effect size)

Small 0.2; Medium 0.5; Large 0.8

1. Multimedia - deeper L f words (W) and pics (P) than words alone (3 of 3, 1.90)

2. Contiguity - deeper L f presenting W and P simultaneously rather than successively (8 of 8, 1.30)

3. Coherence - deeper L when extraneous W, sounds or P r excluded than included (4 of 4, 0.82)

W + P > WwwwwwsssssPppppppp

4. Modality - deeper learning when W r presented as narration rather than on screen text (4 of 4, 1.17)

5. Redundancy - deeper L when W r presented as narration rather than as both narration and on-screen text (2 of 2, 1.24)

6. Personalisation - deeper L when words r presented in conversational style rather than formal style (2 of 2, 0.82)

Personal conversational style ("that's great") > Formal ("correct")

7. Interactivity - deeper L when learners r allowed to control the presentation rate than when they r not (1 of 1, 0.97)

Pause/Start (reply) button > No control

8. Deeper L when key steps in narration r signaled rather than nonsignaled (1 of 1, 0.74)

Key steps SIGNALED > nonsignaled

Cognitive Load Theory (AMEE guide 86)

System 1 thinking (rapid pattern recongnition) vs System 2 (slow, analytical)

4C/ID model (van Merriënboer, 2013)

Symposium speakers Q and A interactive discussion with audience available from AMEE Live as video on demand

1. Limited attention span of current generation of students

Students are able to focus for long periods on what interests them.

Students want to become healthcare professionals and have worked hard to get into training program.

Key is learning objectives, learning pedagogy, and curated or created content.

3. Value add of online learning

IT can be used to broaden access significantly - "broadcast" and provide pesonalised content - "narrowcasting".

More slides for reference/discussion below.

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Cognitive Theory and the Design of Multimedia Instruction: An Example of the Two - Way Street Between Cognition and Instruction Principles of multimedia learning based on a cognitive theory of multimedia learning (number of tests / effect size) Small 0.2; Medium 0.5; Large 0.8 1.

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APMEC 2014 Medical Education Conference eLearning Symposium

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APMEC 2014 Medical Education Conference eLearning Symposium

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http://telroundtable2014.blogspot.sg/

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A round table discussion between a panel of health professions educators with interactive audience participation.
This will include sharing of key take home messages illustrated by examples or short practice narratives of the use of Technology Enhanced Learning in various educational settings.
We anticipate a highly interactive session augmented by online discussions.

Marcus Henning
Sanjay Khanna
Junji Otaki
Kenneth Pinto
Gominda Ponnamperuma

http://www.med.nus.edu.sg/meu/apmec11/programs.shtml
Profiles of the panelists on website above.
Key slides
Poh Sun
"I feel the most important thing to focus on is the learning, rather than the (e) in eLearning"
"I am now convinced that a hyperlinked curated index of digital teaching resources, that reflects the breadth and depth of undergraduate teaching, and postgraduate training is the way forward"

Marcus Henning
"There is a need to create an accessible online learning environment in a regionally diverse learning community such as that exists in New Zealand"
"Coursebuilder is an effective software platform for developing teaching and learning content, which can be embedded in CECIL - a university-wide online interface that integrates discussion threads, assessment, administration, and other learning activities."

Sanjay Khanna
"Technology is flexible and can be used in different ways to facilitate learning."
"Flipped classroom teaching that is designed to actively involve students seems more acceptable to them than didactic lectures."

Junji Otaki
"Even if you are not an expert in the use of IT, you can explore ways of using it."
"To aggregate clinicians' opinions on educational materials, an easy-to-use online system on which a manager can collect and edit opinions while making them anonymous could be useful."

Kenneth Pinto

"When using technology in the classroom, start small and simple, then iterate towards advanced use and outcomes."
"The MOOC wave will also cover Medicine. How should Medical education take advantage of MOOCs?"

My Educational Technology journey began in NUS, where I was the Publications Officer for the Centre for Instructional Technology (CIT). This was around the time that social media was starting to make its way into education. My colleagues are mostly software engineers. Blogs, wikis and other social media eluded them. Through helping educators navigate the world of social media, I got more directly involved with educational technology, rather than just writing about it.
My current areas of responsibility include Massive Open Online Courses (MOOCs), mobile learning and plagiarism prevention. MOOCs were the biggest educational technology trend in 2013. Even NUS, which is relatively averse to putting teaching content online for the world to see, jumped on the bandwagon. We began with a small internal course last year on Essentials of Academic Writing. Currently, two NUS courses are in progress on Coursera: Unpredictable? Randomness, Chance and Free Will by Prof Valerio Scarani from the Centre for Quantum Technologies, and Write Like Mozart: An Introduction into Classical Music Composition by Assoc Prof Peter Edwards from the Yong Siew Toh Conservatory of Music. One more will be launched in February - Reason and Persuasion: Thinking Through Three Dialogues By Plato. This will be taught by Assoc Prof John Holbo.
These are the external (for public) courses that NUS is running on Coursera. But we are also running courses on Coursera only for NUS students. Rather, we are using Coursera as a platform on campus to help with the delivery portion of the flipped classroom. These courses which started earlier this month are for NSmen who are waiting to matriculate. The courses are bridging courses which count for credit. This approach is not really massive (the "M" in MOOCs). They are not open either. So, we call them iBLOCs - Internal Blended Learning Online Courses.
Emphasis on MOOCs is because that's been the majority of my work since the middle of last year. Perhaps we can discuss how these may impact medical education? (There will be a course on Genomic and Precision Medicine and other medicine-related courses on Coursera too.)
Gominda Ponnamperuma
"Whichever the medium of delivery, the role of the teacher, be it as an examiner or as a tutor, cannot be replaced by technology; technology can only assist and enhance the role of the teacher."
"Although judging what is plagiarism is the prerogative of the marking tutor (not the software), an advanced software package that provides information on both the quality and quantity of the overlapping material (i.e. material suspected to be plagiarised) in a more cohesive and synthesized form can certainly help."
"With the help of such software, the onus of detecting plagiarism should eventually shift from the tutor to the learner."

Sharing a short video from the frontier of tech innovation

Maximising your personal productivity

Proposed roundtable discussion setup (see YouTube video below for one setup, actual conference venue hall plan and setup below).

Some questions and points raised during audience and panel discussion

Open vs closed eLearning content for MOOCs
Personal data protection act
How to get student engagement and increased use of eLearning programs

Role of embedding content in curriculum, and role of assessment
Off the shelf vs in house development of platforms
Open source movement
Use of social media eg. Twitter for APMEC
http://www.symplur.com/healthcare-hashtags/apmec/

Social media as part of a new professionalism (Anne Marie Cunningham)
Plagiarism detection software

We had a good turnout at the roundtable discussion (see above).

Reflective critique

1. One purpose of this symposium was to stimulate discussion on the topic of Technology Enhanced Learning, and engage the audience.

2. The objective for choosing this presentation format was to spend more time at the symposium interacting with the audience, and less time on "presentation". The use of a website / blog; announcement of the blog at the 11th APMEC opening ceremony welcome address; and invitation to the audience to email or post on the blog questions or comments was to stimulate audience engagement.

3. There was one blog participant question on the morning before the symposium (on the role of public or private MOOCs); and one blog comment at the symposium (on the type of educational content shared on a teaching / educational blog - public).

4. The role of social media, especially Twitter was raised at the symposium. The usefulness and potential for further stimulating wider audience engagement was discussed. Some comments on the symposium; and the 11th APMEC in general are seen below.

Had a hard time locating the blog Dr Goh Poh Sun was referring to at #apmec, sharing it in case anyone missed it too http://t.co/MmmWBKWvGh Fri Jan 17 23:58:54 PST 2014
(from symposium participant not at opening ceremony)

and

#apmec #meded hope to see exponential increase in tweets at apmec 2015, meded conferences should go global http://t.co/9Bka6lGx7s Sat Jan 18 1:11:54 PST 2014

5. The symposium panelists are in the process of writing a scholarly symposium roundup and reflection piece for publication.

Thank you to all the face to face; and online participants at the symposium on technology enhanced learning @ 11th APMEC 2014!

Goh Poh Sun

(0437hrs, January 23, 2014; Singapore)

"The open-format adopted for the discussion among the panelists and the audience led to an informative exchange of ideas with the participants expressing varied views on the use of technology for teaching and learning. The views reflected, in part, the experiences of the participants that ranged from (a) developing technological support, (b) using technology for mounting online modules and supporting material for medical residents and (c) to MOOCS. An issue raised by a number of participants mirrored my concern as well and was centered on how best to motivate and involve student in self-study of online material. While no single definitive means of motivating students emerged from the discussion related to this theme, I had shared with the participants my experience on adapting the use of in-house online modules to suit student needs. I had developed the online modules with the intention of promoting self-study of principles of sensory physiology and pain. In this context, I shared the data that indicated that while the design of the modules was acceptable to the students, they felt quite strongly that these modules should complement, but not replace face-to-face interaction with the teacher. This propelled me to integrate the modules with a version of the flipped classroom that involved the following student activities in a science course: (a) e-learning, which involved self-directed learning using the online modules. Some of these modules complemented didactic lectures (i.e. complementary modules) while the final module in the series provided supplementary information (i.e. supplementary module), (b) formative assessment in classroom that covered the complementary modules and associated didactic lectures, and (c) group discussion in classroom, which involved discussion of and development of concepts introduced with the supplementary module. While I did not track the pre-classroom or within classroom use of the online modules by the students, the student participation in the classroom activities was relatively more intense throughout the session as compared to an equivalent period of didactic lecture. In a preliminary survey the students also strongly favored this mode of interaction over didactic lecture. Perhaps, with appropriate monitoring and refinement, this mode of enmeshing technology with classroom teaching might become a means of motivating students towards a greater self-study and active learning in classroom setting."

Sanjay Khanna

(1930hrs, January 28, 2014)

"My thinking regarding the symposium session on 'technology enhanced learning' encompasses the ideas of diversity, synchronicity and opportunity. First, diversity refers to the idea that each panellist interpreted the notion of technology enhanced learning differently. My presentation was initially situated around the idea of technical mechanisms we use in our centre to enhance learning. Second, we all somehow synchronised our thoughts into a meaningful whole. And this discussion brought out constructive and evocative discussion from the audience. My initial idea of introducing the technical mechanisms used within our centre to enhance learning was side-tracked to notions of stress associated with increased technology demands. Third, opportunity raises the notion of being able to discuss a very important issue with like-minded educationalists at an international conference, thus building on prior knowledge and skills. I really enjoyed the opportunity to work with a great group of learned panellists and to be able to merge and interact with an informed audience."

(0431hrs, January 29, 2014)

"The ground work or the homework, carried out before the roundtable discussion, was the most exciting. All discussants were on a steep learning curve. The reason for this was that nobody had a concrete idea as how best the discussion should be carried out. However, the rich brainstorming sessions via email that the leader of the session led while showing video examples of similar roundtable discussions in other conferences clarified the expectations and the roles of the discussants. This was particularly helpful, as the session was not a simple symposium where a few speakers stood up and delivered their presentations, one after the other, but a session where the speakers had to inter-twine their narrations to build a coherent picture. Hence, the general learning point that I gained through this is that this session was yet another confirmation of how important the collaborative preparatory work is in planning such a session.

Reflecting on this experience and what we could have done differently, if such an opportunity presents the next time, may be, now that we have some collective experience in such a roundtable discussion, the each presenter could begin as a question and answer session with the audience. Thereafter the speaker could come up with his or her experience and suggestions/recommendations. This is basically flipping the sequence of events upside down. Then, based on the speaker's input the audience could be invited again to ask one or two clarification questions. Hence, each presentation could be structured as follows.

1. Speaker displaying the main question that he/she is going to address as one slide and inviting comments from the audience - 4 minutes.

2. Speaker giving his possible explanation and solution, if it had not already emerged from the audience or confirming the possible solution/explanation, if it had already emerged from the audience - 4 minutes.

3. All panellists responding to one or two clarification questions by the audience - 4 minutes.

So, each speaker's (and panellists') input would be alternated and sandwiched between the audience responses to the main point addressed by the speaker."

(0959hrs, February 1, 2014)

"The session was active and interactive. However, it might be somewhat difficult to understand
the discussion for non-native speakers of English or hard-of-hearing persons.
If we seek wise use of ICT, there might be still room for improvement.
The session was very interesting and I enjoyed thoroughly."

Junji Otaki

(1410hrs, Feb 18, 2014)

"This was the first time I have been involved in a conference using this presentation format. The preparation was done via email.

No doubt some educational technologists may recoil at the use of email to discuss and collate information for a roundtable discussion. However, the technology of choice - email - is one that was immediately familiar to all the panelists.

Where technology is concerned, I think it is important not to alienate people. In this setting, we were in different countries and, as far as I could tell, using technologies at different levels. It would have been counter-productive to suggest something else which may have required a learning curve. Instead, the discussions carried on via email. With Dr Goh doing an excellent job of moderating and summarising the discussions, I felt email served us well.

If I were to collaborate on a similar presentation with colleagues I know are familiar with certain technologies, I would have used a wiki or Google Docs. Email trails can get unwieldy and disjointed. (That said, content on wikis can get unwieldy and disjointed too!) There would be page for each of our contributions, and an overall page to weave the contributions into a coherent whole. The discussion would be separate from the content, and that would take place using email or Wikipedia-style comments, which are separate from the actual content of the entries."

Kenneth Pinto

(1417hrs, February 21, 2014)

# data[].attributes.attachment_link.description
A round table discussion between a panel of health professions educators with interactive audience participation. This will include sharing of key take home messages illustrated by examples or short practice narratives of the use of Technology Enhanced Learning in various educational settings. We anticipate a highly interactive session augmented by online discussions.

# data[].attributes.body
http://casebasedreview.blogspot.sg/

# data[].attributes.attachment_link.readable_text
Resident's notes for Tutorial on Wednesday, Nov 6, 2013 (Case 2066 to 2075, from website below)

Illustrative answers (unedited) from resident spot quiz/tutorial 0745 hrs, Nov 6, 2013
R3

2066: acute infarcts in the left lenticulostriate region from a left MCA occlusion
2067: evolution of a right MCA territory infarct at ther right temporal lobe.
2068: evolution of acute on chronic right MCA infarct with acute right ACA infarct. Possibly right PCA infarct.
2069: rim enhancing lesion in the right occipital lobe possibly evolving haematoma. Ddx. abscess or glioma.
2070: right SCA infarct.
2071: right cerebellar parenchymal haematoma
2072: bilateral thalamic infarct and old left occipitotemporal infarct. ?central vein occlusion. Development of SAH.
2073: acute SAH at the right middle temporal lobe. ?arterial blush at the right posterior communicating artery.
2074: bilateral acute intra-axial haematomas at the right temporal lobe and insula and left basal ganglia. Old lacunes. ?amyloid
2075: ?endstage frontotemporal lobe atrophy with bilateral subdural collections and acute blood at the left frontotemporal lobes.
R3

2066 - Left corona radiata and lentiform nucleus infarct, focal stenosis at left MCA

2067 - Right MCA acute infarct, spares basal ganglia. DDX:herpes encephalitis

2068 - Right MCA infarct (progressive from acute to chronic)

2069 - Right occipital lesion - ? evoloving hematoma

2070 - Roght SCA and IACA infarct, mass effect with hydrocephalus

2071 - Right cerebellar bleed with mass effect

2072 - Communicating hydrocephalus

2073 - Parietal subgaleal hematoma, Right slyvian fissure SAH, No aneurysm on 4VA

2074 - Basal ganglia hypertensive hemorrhagic infarct

2075 - Left frontal hematoma and bilateral SDH, frontal atrophy - chronic infarct

2075: evolution of chronic bilateral SDH with gliosis and ex-vacuo dilation of the ventricles.

2074: evolution multiple hemorrhagic contusion

2073: SAH in the Sylvian fissure, ?source

2072: Communicating hydrocephalus

2071: Evolving cerebellar hematoma

2070: right PICA distribution infarction

2069: ?malignancy, right occipital lesion with surrounding vasogenic oedema and SAH

2068: evolution of R MCA infarct

2067: distal R MCA distribution infarct

2066: left lenticulostriate infarct

Sorry I won't be able to attend tutorial later today as I'm on leave... here is my attempt

2066: left MCA internal watershed acute infarcts
2067:old right MCA territory infarcts
2068:old right MCA infarct and acute right ACA infarct, pontine lacune
2069: atypical abscess
2070:superior cerebellar artery infarct with haemorrhagic conversion
2071: cerebellar parenchymal haematoma
2072:evolving hydrocephalus
2073: SAH from an MCA aneurysm
2074: Basal ganglia parenchymal haematomas (hypertensive haemorrhage)
2075: hydrocephalus ex vacuo

Will the answers be posted on the blog later?

2069: posterior fossa cerebral abscess

2070: right cerebellar infarct

2071: right cerebellar hemisphere bleed

2072: sub arachnoid hemorrhage, old left MCA infarct

2074: sub arachnoid hemorrhage

Acute left MCA infarct - deep lenticulostriate branches not opacifying well

Acute right MCA infarct in the region of the right inferior terminal branches of M2

Evolving right MCA infarct

- subsequent MR images depict ex-vacuo dilatation

Right posterior fossa cystic well rounded mass

Right cerebellar infarct with surrounding mass effect on 4th ventricle and cerebral aqueduct resulting in hydrocephalus (dilated temporal horns)

Right cerebellar hemorrhage

- poorer grey-white differentiation in the entire left MCA distribution

multifocal intrafocal hemorrhages

- infarct right temporal lobe

- infarct right MCA territory

- right superior cerebellar infarct

7. 2072 - chronic lacunar infarct

9.2074 - right temporal haematoma

2066 left lentiform nucleus infarct

2067 right temporal lobe infarct with resulting leucomalacia

2068 right frontotemporal lobe infarct with resulting ipsilateral leucomalacia and lateral ventricular dilatation

2069 rim enhancing mass in the right occipital lobe with effacement of the occipital horn of the right lateral ventricle

2070 right superior cerebellar infarct

2071 right cerebellar haematoma/haemorrhage with effacement of cerebellar sulci

2072 old left mca infarct with developing hydrocephalus.

2073 haemorrhage in the right sylvian fissure and bilateral basifrontal region.

2074 right putamen nucleus haematoma followed by left putamen haematoma and right basal ganglial haemorrhage extending to the right temporal lobe.

2075 bilateral hypodense subdural collections possibly subdural hygromas with left frontal haemorrhage and hydrocephalus.

Resident's notes for Tutorial on Thursday, Dec 5, 2013 (Case 501 to 511, from website below)

Illustrative answers (unedited) from resident spot quiz/tutorial 0745 hrs, Dec 5, 2013
R1
501: Miliary TB
502:
503: Widened mediastinum on CXR. CT scan shows aortic thrombus ? from ruptured aorta
504: Consolidation at lingular lobe with air bronchograms
505: left bronchogenic carcinoma and large left pleural effusion with collapse/consolidation of left lung field.
506: Mesothelioma secondary to asbestosis
507: Metastatic pulmonary nodules
508: Pulmonary nodules
509: obstructive hydrocephalus
510: progression of large right pleural effusion

R1
501: Pulmonary tuberculosis
502: APKD with ruptured AAA
503: Aortic arch aneurysm with thrombosis
504: Primary lung malignancy in lingular segment
505: Squameous cell carcinoma with large malignant pleural effusion
506: Malignant mesothelioma
507: Multiple pulmonary metastases on chemotherapy (portacath in situ), enlarged left atrium
508: Possible primary breast malignancy (breast implants) with multiple pulmonary metastases / nodal metastases
509: Neurofibromatosis
510: Multiple pulmonary abscesses

R2
501: right upper lobe tree in bud opacities. Pulmonary TB
502: ruptured AAA with retroperitoneal haematoma
503: arch of aorta aneurysm with luminal thrombus. Retrosternal goitre
504: left spiculated lung mass: SCC
505: necrotizing pneumonia with pleural effusion
506: left malignant mesothelioma
507: pulmonary metatases on treatment (portacath)
508: pulmonary mets and mediastinal lymphadenopathy on treatment
509: right mca infarct post cranioplasty with hydrocephalus and vp shunt in situ. Left upper mediastinal mass vs chest wall mass
510: empyema

R2
501: Tree-in-bud opacities on CT, reticulonodular opacities on CXR, may represent TB or other bronchiolitis
502: Ruptured AAA, adult polycystic kidney disease (associated with AAA)
503: Fusiform aneurysm of aortic arch with eccentric mural thrombus
504: Spiculated lung nodule, suspicious for malignancy
505: Perihilar mass with central necrosis / cavitation. Likely SCC with malignant pleural effusion
506: Mesothelioma
507: Pulmonary metastases. Liver lesion ? cyst
508: Pulmonary metastases. Bilateral breast implants ? previous bilateral mastectomies from breast ca
509: Multiple neurofibromas in neurofibromatosis
510: Loculated pleural effusion, possible empyema

R2
Case 501 - Tree in bud opacities, likely TB

Case 502 - Ruptured/Leaking AAA

Case 503 - Intramural haematoma

Case 504 - Solitary pulmonary nodule with ill-defined spiculated margins. Likely neoplasm

Case 505 - Necrotic cavitating lung mass with narrowing of left bronchus + pleural effusion

Case 506 - Mesothelioma

Case 507 - Scattered bilateral pulmonary nodules - likely metastases given the presence of porta-cath. Primary unknown.

Case 508 - Scattered bilateral pulmonary nodules and enlarged right hilar node - likely metastases given the presence of porta-cath. Bilateral breast implants noted - ?possible primary breast Ca

Case 509 - Plexiform neurofibroma (enhancing mass enlarging foramen ovale) with large left neck/apical mass

Case 510 - Rim-enhancing loculated fluid collections with debri within. ?Empyema

R3
510. Multiple pulmonary abscesses. Acute angles with pleura
509. Neurofibromatosis I with plexiform neurofibroma
508. Status post bilateral mastectomy and breast recon with pulmonary metastases. Small splenic lesion.
507. Pulmonary and hepatic metastases on chemotherapy
506. Mesothelioma
505. Left hilar carcinoma. Likely SCC with malignant effusion and T12 wedging.
503. Aortic arch aneurysm with acute aortic syndrome.
502. Aortic aneurysm rupture with surrounding haematoma.
501. Diffuse bronchiolitis. Non specific cause.

R3
501 - miliary TB/metastasis
502 - ruptured abdominal aortic aneurysm
503 - unfolded aortic arch with soft atherosclerotic plaques
504 - left lower lobe focal consolidation
505 - left hilar cavitating mass with left lower lobe collapse and severe effusion
506 - left sided mesothelioma or pleural metastasis
507 - bilateral pulmonary metastases
508 - bilateral pulmonary metastases with mediastinal and hilar lymphadenopathy
509 - left sided neurofibroma and right base of skull neurofibroma
510 - right sided multiple empyema

R3
501: miliary tb
502: ruptured aaa
503: aortic arch aneurysm
504: spiculated nodule left lower lobe
505: left pleural effusion with soft tissue nodules possibly representing pleural mets
506: left mesothelioma
507: bilateral pulmonary mets
508: bilateral pulmonary mets. Bilateral breat implants
509: mass in left upper zone possibly a metastatic focus. Hydrocephlus with mass in the right deep neck space extending into the foramen ovale and sphenoid sinus
510: right loculated pleural effusions; possibly infective in nature

Resident's notes for Tutorial on Thursday, Jan 9, 2014 (Case 2324 to 2333, from website below)

Illustrative answers (unedited) from resident spot quiz/tutorial 0745 hrs, Jan 9, 2014

2333: retrolisthesis of C5/6 causing narrowing of spinal canal anteriorly

2332: retropharyngeal soft tissue swelling anterior to C1-3 causing narrowing and deviation of trachea to the left

2329: left parietal crainectomy complicated by intracranial bleed and hydrocephalus causing herniation of brain out of cranial defect

2328: right caudate mass causing mass effect and midline shift to the left with narrowing of right lateral ventricle

2327: left thalamic enhancing lesion

2326: left thalamic bleed followed by subsequent right-sided thalamic bleed

2325: hyperdense enhancement of right thalamus - right thalamic bleed

2324: hyperdense focus at right thalamus - right thalamus hemorrhage. unsure what lesion near sagittal suture is.

2324: Right basal ganglia haematoma with perilesional oedema and adjacent mass effect and mild distortion of right lateral ventricle. Periorbital haematoma noted. Meningioma right frontal skull.

2325: right intracerebral haematoma with perilesional oedema and mass effect associated with effacement of right lateral ventricle and subsequently showing temporal evolution.

2326: Left basal ganglia haematoma with intraventricular extension with interval increasing in size. Subsequently developed right basal ganglia haematoma.

2328: Lymphoma with perilesional oedema, mass effect & left midline shift & distortion of right lateral ventricle.

2329: SAH then developed ACA infarct. Then SDH with interval left craniotomy with herniation of brain through the cranial defect and intracerebral haematoma. Then developed gross hydrocephalus with increase herniation of brain through the defect.

2330: SDH with fracture of left mandible and pneumocephalus

2332: retropharyngeal abscess secondary to foreign body

degenerative changes in the cervical spine with central canal narrowing at C5-6 due to disc cervical complex at C5/6

right paratracheal heterogenous mass causing deviation of trachea to the left

right extra-axial hematoma with left SDH

Pseudo Subarachnoid hemorrhage, global cerebral edema with subsequent decompressive left craniectomy

and generalised cerebral atrophy subsequently

2324. Right putamen hematoma + right high parietal calcified meningioma

2325. Right putamen hematoma

2326. Bilateral thalamic hemorrhage

2327. Bilateral thalamic infarct

2328. Right putamen mass with associated peri-lesional oedema involving the parietal and frontal white matter with gray matter sparing.

2329. Bilateral extensive MCA infract with resultant mass effect and left parietal craniectomy. There is interval increase in oedema and mass effect along with encephalomalacia and gliosis associated with ex-vacuo dilation and herniation of cerebrum through the craniectomy site.

2330. Right scalp swelling with intra-orbital emphysema and left mandibular fracture

2331. Sagittal sinus thrombosis.

2332. Right paratracheal mass with internal foci of air with resultant mass effect and left-ward displacement of the trachea.

2333. Cervical spondylotic changes worst at C5/6

2324: DAI with incidental calcified meningioma

2325: right basal ganglia haematoma evolving from acute to chronic

2326: bilateral basal ganglia haematomas likely hypertensive with ivh

2327: artery of percheron infarct subacute

2329: sah complicated by bilateral mca and aca infarcts with severe volume loss eventually

2330: head trauma with left mandibular ramus #, l orbital emphysema, right scalp haematoma and trace sdh

2331: dandy walker variant

2332: retropharyngeal fluid collection/abscess with mediastinal extension

2333: opll and cervical spondylosis with central canal stenosis at c5/6

2324 - Right basal ganglia hyperdense tumour and right frontal osteoma

2325 - Right basal ganglia hemorrhagic infarct

2326 - Bilateral basal ganglia hemorrhagic infarct

2327 - Thalamic infarct - left thalamus with hemosiderin staining

2328 - Right basal ganglia hyperdense tumour

2329 - SAH > Left MCA infarct > craniectomy > left extra-axial collection and bleed > hydrocephalus

2330 - Right parietal scalp hematoma, no skull vault fracture

2331 - Superior sagittal sinus thrombosis - pre and post treatment

2332 - Prevertebral abscess at right paratracheal with likely fish bone

2333 - Cervical spondylosis, no cord signal change

2324 - Tiny right basal ganglia hematoma with incidental meningioma

2325 - Right basal ganglia acute bleed/hematoma - likely hypertensive

2326 - Bilateral basal ganglia bleed, left with intraventricular extension - likely hypertensive

2327 - Bilateral thalamic lesions (DDx: Ischemic, Metabolic, Neoplastic)

2328 - Right basal ganglia mass with adjacent mass effect and cerebral edema - ?GBM

2329 - SAH, post right burrhole and left craniectomy with hematoma beneath, subsequently cx by aca and mca infarcts bilaterally

2330 - SDH along falx, left mandible fracture, right temporal cephalohematoma

2331 - Dandy Walker Variant

2332 - Retropharyngeal abscess

2333 - OPLL but no definite cord compression

2324 right basal ganglia acute haematoma, bilateral old lacunar infarcts, calcified right frontal meningioma

2325 right basal ganglia acute haematoma

2326 bilateral bg acute haemorrhage with left intraventricular extension

2327 high signal in bilateral thalami and periaqueductal gray wernicke encephalopathy

2328 glioblastoma multiforme with left sided hydrocephalus

2329 acute SAH secondary to ruptured right MCA aneurysm complicated by bilateral severe vasospam with large bilateral cerebral infarcts/haemorrhagic conversions

2330 traumatic SDH along the falx cerebri with right scalp haematoma and fracture of left mandibular condyle and orbital emphysema

2331 no abnormality seen?

2332 esophageal FB with perforation and abscess/prevertebral collection

2333 cervical spondylosis with spinal stenosis worst at c5/6

2324: right basal ganglia bleeding ....... location, there is surrounding edema and mass effect on the frontal horn of the right lateral ventricle.

2325: Primary brain tumor with calcification with intralesional bleeding ( most likely oligodendroglioma)...... mass effect on the right lateral ventricle with surrounding edema.

2326: bilateral basal gangila bleeding with extension into the left lateral ventricle most likely hypertensive....... location, surrounding edema and mass effect on the left lateral ventricle.

2327: Bilateral thalamic infract..... hypodense in Ct, high in flair low in T1, diffusion restriction and faint peripheral enhancement.

2328: CNS lymphoma centered over the right temporal lobe and the right basal ganglia and crossing the mid line..... hperdense in CT, hypo in flair with diffusion restriction and intense contrast enhancement.

2330: left mandibular ramus displaced fracture with surrounding haematoma.

2331: communicating hydrocephalus...... dilatation of all ventricles,

2332: retopharangeal abscess..... soft tissue... air pockets

Announcement of resident tutorial, February 10, 2014 @ 0745am

(answers to follow in 24 hours)

Illustrative answers (unedited) from resident spot quiz/tutorial 0745 hrs, Feb 10, 2014

2486- meningioma
2489- left occipital haematoma with perilesional oedema, showing interval increase in size. Subsequently shows temporal evolution with ex-vacuo of the left lateral ventricle and area of gliosis.
2490- SAH with blood seen in the falx. Bilateral basifrontal haemorrhagic contusions show interval increase in size and worsening of cerebral oedema with mild right midline shift and subfalcine herniation, followed by temporal evolution.
2491- acute on chronic left convexity SDH with right midline shift and subfalcine herniation with subsequent temporal evolution. Chronic right parafalcine SDH.
2491- left extra-axial haematoma, followed by drainage with tension pneumocephalus and subsequent resolution.
R1

Case 2486 - meningioma at right convexity

- homogenously enhancing extra-axial lesion with tail seen

Case 2487 - CSF density lesion in left temporal region that doesn't suppress on FLAIR, hypodense on CT, non enhancing

Case 2489 - evolution of a left cerebral infarct with hemorrhagic conversion, subsequent enchephalomalacia and ex-vacuo dilatation

Case 2490 - deep white matter confluent hypodensity with relative sparing of white matter, minimal edema

- Glioblastoma multiforme vs CNS lymphoma

2488 - Left maxillary sinus and zygomatic arch fracture. left temporal lobe contusional hemorrhage with gliosis, left temporal region epidermoid

2488 - left frontal lobe focal grey matter change - ? cortical tubers

2489 - Left parietal lobe acute bleed and occipital lobe infarct

2490 -Bifrontal contusional hemorrhage and SAH (temporal progression)

2491 - acute on chronicleft subdural hemorrhage (temporal evolution)

2492 - bilateral SDH - drained later on

2493 - Right lateral ventricle subependymal hemorrhage with gliosis, left MCA and PCA infarct with hemorrhagic conversion/hemorrhagic stroke

2495 - Corpus callosum mass/tumour - lymphoma/astrocytoma/GBM

2489 - Left/parietal occipital bleed

2486 right parietal meningioma

2487 left parietal epidermoid cyst

2488 left parietal cortical acute infarct

2489 left occipital intra-parenchymal haemorrhage

2490 bifrontal haemorrhagic contusions with acute SDH/SAH

2491 acute on chronic left SDH with subfalcine herniation

2492 subacute left SDH with ?pneumocephalus bilaterally

2493 occlusion of left M1 with large left MCA acute infarct and subsequent haemorrhagic conversion; old infarcts of right basal ganglia

2494 generalised bone changes of hyperparathyroidism/ESRF

2495 white matter lesions in the splenium of the corpus callosum ?glioma

2486. Meningioma, extra-axial lesion... CSF cleft, obtuse angel with underlying dura.... Buling of the adjacent brain parenchyma.... Intervening vessels between the lesion and the brain parenchyma... bine hyperstosis.... Homogenous intense enhancement .... Enhancing dural tail..

2487. Extra-axial hematoma....initially hyperdense in CT...then isodense....On MRI hyperintense in T2 and FLAIR and isointense at periphery and hyperintense center. Susceptibility artifact noted within the lesion on Gradient echo.

2488. A cute cortical inafarction in the left high frontal lobe..... on CT subtle lose of gray-white matter differentiation ... Om MRI ...focal area of prolongation of T2 and FLAIR with corresponding diffusion restriction.

2489. Large acute Intraparenchymal hematoma hyperdense in CT with perilesional edema , On FLAIR hyperintense indicating acute hematoma .chronic sequel of intraparenchymal hematoma... leukoencephalomalacia with ex-vacue dilatation of the lateral ventricle.

2490. There stages bifrontal hemorrhagic contusions with subarachnoid hemorrhage and associated edema evident by effacement of the sulci and lose of gray-white matter differentiation. Then , the hematoma become isodense with persistent local brain edema and mass effect on the lateral ventricles.. features are in keeping with temporal evolution. After that , there gliotic features started to appear evident by increase hypodensity with dilatation of the lateral ventricles.

2491. Large left fronotparietal subdural hematoma ... appears subacute in the initial scans and chronic on the later scans...It is associated with effacement of the adjacent brain parenchyma effacement of the lateral ventricle, subfacine herniation and uncal herniation.

2492. Left extra-axial collection causing ffacement of the adjacent brain parenchyma effacement of the lateral ventricle. Subsequent scan showed large pneumocephalus which has been evacuated .

2493. Large acute ischemic infraction at the territories of the left MCA with another infraction seen at the territories of the left ACA likely due subfacine herniation.... The infract get complicated with hemorrhagic conversion... hyperdense hematoma at the center on the infarction... suitability artifact on gradient...Finally, temporal evolution is evident by small size hematoma and less dense.

2494. Renal-osteodystrophy ...... diffuse skull thickening "loss of distinction between the inner and outer table and a granular deossification of the skull, salt and pepper skull appearance.

2495. 1.Hemorrhagic infraction involving the posterior part of the corpus ccallosum and splenium as well , 2. Rathke cleft cyst.. well defined T2 hyperintense cellar lesion which his separated from the pituitary gland... Subsequent Images show leukoencephaloma lacia of the corpus callosum as chronic sequel of hemorrhage..... hyperdensity seen in the pituitary fossa likely Rahke cleft cyst containing high pretentious contents.

2496. Multiple perineural cysts seen at the sacral neural formena .... High intensity in T2 and low in T1... not suppressed in fat suppression sequences. L5 enchondroma , well defined, hypointense in T1 nd hyperintense in T2 with central areas of hypointensity might represent areas of calcification. No suppressed on fat sat sequences

Some additional reading below

Announcement of resident tutorial, Monday, March 10, 2014 @ 0745am

Selected key images below from tutorial participants

Illustrative answers (unedited) from resident spot quiz/tutorial 0745 hrs, March 10, 2014

Case 326: Large left suprarenal mass, possibly adrenal carcinoma with liver metastasis

Case 327: Sigmoid colon carcinoma

Case 328: Left renal angiomyolipoma

Case 329: Ovarian carcinoma

Case 330: Left distal ureter TCC with obstructive nephropathy

Case 331: Calcified liver granuloma

Case 332: Hepatic cavernous hemangioma

Case 333: Left mid-pole renal cyst, possibly Bosniak 3

Case 334: Extensive retroperitoneal and peri-duodenal fat stranding with multiple abscesses in the head and neck of pancreas as well as thickening of the duodenum, splenic infarct

Case 335: Renal cell carcinoma

326: left renal mass with mets to liver

327: large bowel obstruction

328: right ovarian ca with ascites and peritoneal mets

329: uterine mass invading to adjacent rectal mucosa

330: left hydronephroureter secondary to ureteric stricture at distal ureter

331: calcified aortic abdominal aneurysm

332: liver mass, hemangioma

333: solid left renal mass

335 - Hypodense nodule in aortocaval region. May be neurogenic tumour or lymph node.

334 - Fat stranding around pancreas. May be pancreatitis. Hypodense nodule in pancreatitic head with pancreatic duct and bile duct dilatation.

333 - Hypodense nodule in left kidney interpolar region.

331 - Hyperdense mass in liver. May be previous lipoidal treatment for HCC.

330 - Obstructing left distal ureteric calculus with left hydroureteronephrosis.

328 - Right adnexal partially cystic mass with ascites. Suspicious for ovarian malignancy.

327 - Large left retroperitoneal mass. ? Haematoma. Prominent large bowel loop.

326 - Large left perinephric mass compressing left kidney. Liver cyst. ? Resolving haematoma or cystic neoplasm.

326: Left cystic RCC with hepatic metastases
327: sigmoid volvulus.
328: ascites with peritoneal nodularity and umbilical nodule ? metastatic mucinous adenocarcinoma. Left renal AML.
329: large uterine fibroids.
330: obstructing left distal ureteric calculus with hydronephrosis/hydroureter and reduced contrast excretion.
331: post TACE left lobe HCC. Smaller radio dense nodules in liver may represent siderotic nodules.
332: segment 7 haemangioma
333: left renal hyperdense cyst.
334: colon cut off sign on topogram. Splenic and pancreatic lacerations with likely pancreatic duct involvement and suggestion of duodenal haematoma. ? haemoperitoneum. Trauma.
335: Left adrenal nodule and aortocaval lymph node -> metastases?

Selected key images after case discussion

Resident tutorial, Thursday, May 29, 2014

Non TB mycobacterial infection

Focus on comparing and contrasting - neck/supraclavicular fossa, superior mediastinum, lung fields, diaphragmatic contours in 10 examples above

Tutorial Notes for Monday, June 30, 2014 @0745hrs

661: Right anterior 1st rib chondral calcification (better seen on last image - lesion is end-on at the tip of anterior 1st rib)

662: Right upper zone Primary TB

663: Trachea deviation to the left. Neck mass. Increased density just adjacent to trachea.

664: Right middle lobe collapse

665: Progressive malignant effusion over serial studies. Lung cancer.

666: Stanford A aortic arch dissection

667: Trachea deviation to the right. Goitre. Increased neck soft tissue density

668: Right upper zone loculated pleural effusion. Diffuse airspace changes, getting more confluent on progressive images. Cavitation seen in later images. Worsening chest infection.

669: Left hilar lymphadenopathy with brain mets. Lung cancer. Nodule also seen over the left posterior 6th rib on CT scout image.

Other take-home messages:

660: previous infective process may represent TB in local context, right apical cavitating mass with internal calcification along with left apical scarring.

661: Bone island from the anterior aspect of the right 1st rib.

662: Right apical miliary nodules differentials: infection/ inflammation/ malignancy

663: superior mediastinal mass with left-ward tracheal deviation.

664: middle lobe collapse or consolidation.

665: lung CA with lytic/sclerotic bony metastases and pleural effusion.

666: Stanford A aortic dissection with thrombosis of the dissection lumen with extension onto the left common carotid artery, left subclavian artery and right common carotid artery.

667: multinodular goiter with associated right-ward tracheal deviation

668: metastatic right superior pleural mass with associated lung nodules, interstitial thickening and ascites.

669: lung CA (left hilar) with hilar and mediastinal lymphadenopathy, brain metastases involving the brain parenchyma and leptomeningeal involvement.

660: Bilateral upper zone consolidations, worse on the right.

661: Right upper zone nodule at the medial aspect of the posterior 5th rib.

662: Right upper zone consolidation

663: Trachea deviation to the left. Superior mediastinal mass.

664: Right middle zone consolidation

665: Right pleural effusion. Right upper zone mass. Patient is likely supine on CXR. Better seen on CT.

666: Aortic arch aneurysm.

667: Trachea deviation to the right. Central narrowing of trachea calibre. Goitre.

668: Diffuse airspace changes of both lungs. Right upper pleural collection, likely loculated effusion.

669: Left hilar mass with brain metastasis. Metastatic lung cancer

670: Right upper lobe collapse. elevated right hilar.

Illustrative answers, and learning points (reflection takeaways) from tutorial (unedited) from resident spot quiz/tutorial 0745 hrs, July 3, 2014

550 - left atrial enlargement

551 - bilateral enlarged hilum maybe due to enlarged lymph nodes

552 - left 3rd and 4th rib and right 4th and 5th rib fracture

553 - raised right hemidiaphgram

555 - right lower lobe atelectasis

557 - anterior mediastinal mass

558 - massive cardiomegaly with ascites and distended IVC, possibly due to valvular heart disease

559 - Fractured left clavicle

"Thank you for your session. The main thing I've learnt is perspective on the learning process in radiology. In a new and unfamiliar environment it is easy to be overwhelmed, but it is good to be reminded on the principles of learning and improving in this discipline: active practice, experience and self-reflection."

550: Bronchiectasis - "tramlining" of the airways

551: Left hilar mass - obliteration of hilar structures with adjacent left mizone atelectasis

552: No abnormality is seen.

553: Right apical pneumothorax - faint pleural line at lateral aspect of right upper zone

554: Paediatric gastric outlet obstruction - prominent stomach gas shadow

555: Right lower lobe pneumonia - right lower zone airspace opacification with a right pleural effusion (blunting of the right CP angle and thickening of the right minor fissure)

556: Left lower zone interstitial pneumonia - increased interstitial markings at the left lower zone

557: Puncture of the right SVC after insertion of a right central venous catheter

558: Portal venous hypertension with ascites and worsening cardiomegaly

559: Solitary pulmonary nodule at the right lower zone, adjacent to the right heart border

550: Cardiomegaly. ?Right heart failure due to prominent right atrium. Increased cardiothoracic ratio.

551: Left ventricular aneurysm. Left lower zone mass, seemingly arising from left ventricle. Pulmonary edema.

552: Straightening left heart border. Mitral stenosis

555: Right pleural effusion. Loculated effusion in the right horizontal fissure.

557: Lymphoma. Locally invasive mediastinal mass

558: Pericardial effusion, large ascites. Splaying of carina.

551- anterior mediastinal mass projected over the left lower zone.

552- hyperinflation of the lungs with flattening of bilateral hemidiaphragms

557-posterior mediastinal mass

558- globular heart with ascites

551: Anterior mediastinal mass

- obtuse angle with the left heart border

552: retrosternal thyroid - mild narrowing of the upper airway

553: Normal, suboptimal inspiratory effort

555: right pleural effusion, obliterated costophrenic angle with fluid level.

557: lymphoma with collapse/consolidation of the right lower lobe.

558: Globular heart, with pleural effusion and ascites

551 - thoracic aortic aneurysm

554 - Enlarged gastric bubble, ?pyloric stenosis

555 - right middle lobe pneumonia (obscures right heart border)

557 - Mediastinal lymphadenopathy

558 - large pericardial effusion + ascites

559 - sliver of free air under right hemidiaphragm

Efficient learning may not merely be through day-to-day practice, and shd be complemented by reflection and interaction."

551: Left anterior mediastinal mass. Differentials: infection/ neoplastic process.

553: Left retrocardiac mass.

555: Right lower lobe consolidation.

557: Lymphoma, confluent mediastinal nodes with no invasion or vessel compression.

558: Pericardial effusion, bilateral pleural effusion, ascites

"I learnt about learning efficiently today; which does not rely purely on volume but instead relies on the systematic acqusition of knowledge, daily application of said knowledge and receiving feedback on my performance."

1) Recognise normal chest xrays

- Doing cases VS textbook learning

3) My role as a radiologist. Accurate, confident, fast."

"Thank you for the introductory session today.

Learnt that a career in radiology is a learning process of pattern recognition of which day to day work may not be able to fulfill on its own. It is supplemented with using other resources such as books/ electronic content."

550: Prominent right paratracheal stripe

551: Anterior/middle mediastinal mass, superior x-ray with concomittant left lower lung zone airspace changes

552: Neck lesion with mass effect on trachea - underlying thyroid pathology

553: fine retinoculonodular opacities both lung fields

554: Child with linear reticular changes - viral bronchiolitis with no focal consolidation

555: Right subpulmonic effusion with mid to lower lung zone atelectasis, suggest supine x-ray to confirm effusion

556: Apparent fusiform dilatation of aorta - aortic aneurysm

557: Right mediastinal and hilar mass with necrosis - SCC or TB, favouring the prior. Resultant right bronchus intermedius truncation right middle and lower lobe collapse, SVC obstruction, reactive pericardial effusion

558: Cardiomegaly with right sided pleural effusion, gross ascites, normal liver. Decompensate heart failure

559: Right subdiaphragmatic lucency - ? pneumoperitoneum, chiladitti.

"Regarding what i have learned from the session this morning, I can summarize it in the following two points:

A. Day to day clinical work is a key factor in the learning process where we can express our self and get a feed back.

B. Comparing and contrasting features is the corner stone in recognizing different disease process."

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Postgraduate CPE/CPD Lecture on Orbital Imaging

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Undergraduate Chest Radiology Pathology correlation lecture

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